THE DEPENDENCE OF THE INDICES OF CENTRAL HEMODYNAMICS AND SYNDROME OF ENDOGENOUS INTOXICATION FROM ABDOMINAL PRESSURE IN TERMINAL STAGE OF PERITONITIS
Muradov A.M., Akilov Kh.D., Shumilina O.V., Kakharov M.A.
The department of efferent medicine and intensive therapy of TIPGPMP
The department of anesthesiology and reanimatology TIPGPMP
The department of surgery with course of topographic anatomy KhD TIPGPMP
Increasingly important for evaluation of the patient, forecasting the severity of the disease and treatment outcomes acquires indicator of intra-abdominal pressure, which affects all organs and body systems, including the cardiovascular system, manifested by inhibition of the indices of Central hemodynamics. The article presents the results of monitoring of the parameters of Central hemodynamics 24 patients in the terminal stage of peritonitis in the preoperative period and at different times after the surgery. In parallel was monometry intra-abdominal pressure. Clinical observations have shown that an increase intraperitoneal pressure to levels I and II degrees has an identical effect on the indices of Central hemodynamics. Among the surveyed, there is reduction of the pay and minute performance of the heart due to the decreasing venous return to the heart. Toxemia accompanied by a decline in heart emission and support perfusion of tissues was provided by a moderate ascending indicators poststrain result of voltage humoral factors. The obtained results showed that patients in the terminal stage of peritonitis observed gypokinetical type of circulation, which is characterized by pronounced hypovolemia and reduced poststrain. Against the background of peripheral vascular insufficiency noted the inconsistency of the Central mechanisms of hemodynamics, due to the depression of the myocardium contractile function. Indicator intraperitoneal pressure is a prognostic criterion of the severity of the syndrome of endogenous intoxication and can be applied at the preoperative stage of examination and treatment of patients in the terminal stage of peritonitis.
1. Dolina O.A. Anesteziologiya i reanimatologiya [Anesthesiology and Intensive Care]. Moscow, Meditsina Publ., 2007. 544p.
2. Malahova M.Ya. Endogen intoxication as reflection compensational realignments of the change processes in organism.Efferent therapy, 2000, vol.6, no. 4, pp. 3-14.
3. Hamidov D.D. Anesteziologicheskoe posobie i lazeroterapiya v kompleksnom lechenii bol'nyh s peritonitom.Kon.med.nauk. Diss [Anesthetic guide and laser therapy in complex treatment patients with peritonitis. Kn. Med. Sci. diss.]. Dushanbe, 2007. 135 p.
4. Shumilina O.V. Nepryamoe elektrohimicheskoe okislenie v kompleksnom lechenii detoksikatsionnoy funktsii legkikh u bol'nyh peritonitom. Kon.med.nauk. Diss. [aIndirect electrochemical oxidation in complex treatment of detoxication functions of lungs in patients with peritonitis. kn. med. sci. diss.]. Dushanbe, 2012. 156p.
5. Basu A., Pai D.R. Eagly elevation of intra-abdominal pressure after laparotomy for secondary peritonitis: a predictor of relaparotomy. World Journal of Surgery, 2008, Vol.32, no. 8, pp. 1851-1856.
6. Morgan G.E., Mikhail M.S. Klinicheskaya anesteziologiya (kniga tret'ya) [Clinical anesthesiology (the third book).]. Moscow, BINOM Publ., 2003. 304 p.
7. Perez. D., Wildi S., Demartines N. et al. Prospective evaluation of vacuum-assisted closure in abdominal compartment syndrome and severe abdominal sepsis. The Journal of the American College of Surgeons, 2007, Vol. 205, no. 4, pp. 586-592.
8. Sandra R.V. Abdominal compartment syndrome. Annals of Saudi medicine, 2007, Vol.27, no 4, pp. 183-90.
Information about the authors:
Shumilina Ol'ga Vladimirovna — the assistance of department of efferent medicine and intensive therapy TIPGPMP, cn. med. sci.; Tel: (+992) 900002345; e-mail: email@example.com